The Signs and Symptoms of Hypothyroidism
What is the Thyroid Gland?
The thyroid is a small gland located in the front of your neck, just below your voice box, or “Adam’s Apple”. It’s a small gland, but its duties in regulating functions of your body and maintaining your health are tremendous. It all works in quite a mechanical way, but the basic idea is that under control of the pituitary gland, the thyroid intakes iodine from the foods we eat, and in combination with the amino acid Tyrosine, converts it into thyroid hormones. These thyroid hormones are known as triiodothyronine, most commonly referred to as T3; and thyroxine, most commonly referred to as T4. From there, T3 and T4 are distributed throughout the body and regulate our metabolism. An excess or insufficiency of thyroid hormones can lead to many overlapping symptoms and completely throw life as we know it totally off balance.
What is Hypothyroidism and How Do You Get it?
When your doctor tells you that you have hypothyroidism, it sounds pretty scary. Remember it is a manageable disease, and once you begin treatment you will feel soooo much better. Even though it may take a little time to get your medications right, you will be able to look back and realize how many things this gland has affected. It's quite astonishing that one little gland can impact so many parts of your body.
All hypothyroidism means is that you have an underactive thyroid. Your thyroid isn’t producing enough of the thyroid hormone thyroxine to perform the monumental functions it is designed to perform. It regulates your metabolism, which in turn regulates many, many bodily functions. When you are experiencing untreated hypothyroid symptoms, you truly feel like your body is giving out. The good news is that it can be easily treated and you can get back to feeling normal again.
Hypothyroidism can result from a few different things. One of them is the autoimmune disorder "Hashimoto’s thyroiditis." It can also result from treatment for hyperthyroidsim, which essentially occurs because your thyroid is producing too much thyroxine. The treatment for hyperthyroidism includes the use of radioactive iodine. Your thyroid uptakes the iodine and is in essence, killed off. As the excess thyroxine leaves your body, you end up with some degree of hypothyroidism. The good thing is your doctor will be able to begin treatment right away.
Some people are born without a fully developed, normally functioning thyroid gland. Some people developed nodules on their thyroid as a result of receiving x-rays when they were younger, before precautions were being taken to guard against radiation damage. Lithium can also cause temporary hypothyroidism. Whatever the reason, the symptoms are the same. It is a whole body disease, but it comes on quietly and many times over a period of years. Typically, depression is one of the first symptoms of hypothyroidism, but unfortunately, a thyroid test is rarely ordered at this early stage. Many of us who have experienced untreated symptoms feel like our mind and our body are completely falling apart. Your entire body slows down, along with most of its functions, and continues to slow down if left untreated.
- Dry, Scaly, Itchy Skin
- Intolerance to Cold Cold Hands and Feet
- Loss of Memory
- Achy joints
- Dry Hair/Scalp
- Hoarseness/Raspy Voice
- Weight Gain with or without a lowered appetite
- Constipation Extreme fatigue
- In women, longer and heavier, or absence of, menstruation
- Dry eyes
- Cracked, brittle fingernails
- Lowered, or absence of, libido
- Lessened ability to pay attention/lowered comprehension
- Lowered heart rate
- Goiter (swelling of the thyroid)
- Muscle weakness/fatigue
It is important to remember that it hypothyroidism symptoms come on slowly--sometimes over a period of years. As your metabolism slow further and further, the symptoms become more plentiful, more bothersome and more pronounced.
Your doctor will feel (palpate) your thyroid to check for any nodules or swelling. He will order a simple blood test to check the levels of your thyroid hormones. Many doctors will order a test of your TSH and T4 levels. A TSH test measures your Serum Thyrotropin, which is a thyroid stimulating hormone. TSH is produced by your pituitary gland and is the hormone that prompts your thyroid gland to release T3 and T4. If your TSH level is high and your T4 level is low, it is a very good indication that your thyroid is underactive and is not producing enough thyroid hormones to support your metabolism. Some labs still consider a TSH of above 6 to be high, however, it is now being recommended that anything above a 3 needs to be taken under consideration--at least for further testing. Anything between a .3 and 3 should be considered normal. Many people feel better with a TSH around 1.
There are many other thyroid tests that can be ordered depending on your doctor, but the above are the most common. In addition to a blood test, your doctor may order an ultrasound of your thyroid gland to check for any abnormalities. This is usually done in cases where the doctor feels an abnormality when he palpates the gland at your visit.
As I discussed earlier hypothyroidism is easily treatable with a daily dose of synthetic thyroid medication like Levothroid or Synthroid. There is also a natural desiccated pig thyroid medication called Armour Thyroid. The pills are small, and side effects are extremely rare. Normally your doctor will start with a low dosage, and then re-test your thyroid levels in 6-8 weeks because it takes that long for it to totally get in your system. If your levels aren't right, he will adjust your dosage and re-test again until your lab results come back normal. The best thing is that as the hormone is re-introduced at the correct levels, your symptoms will begin to correct themselves, many times even the weight gain! Slowly but surely, you will get back to normal. Your brain fog dissipates, your hair stops falling out, and you re-gain your energy. Remember, though, that current TSH lab values are higher than what the American Association of Endocrinologists has recommended. If you still don't feel right, ask to have your medication adjusted again and ask to have more tests run. If you can't get your family doctor to listen to what your symptoms are because the lab ranges are considered to be within the normal range, ask to be referred to an endocrinologist. You need a doctor who treats your symptoms--not just the lab values.
- Hypothyroidism Risk/Symptoms Checklist on About.com
Hypothyroidism Risk/Symptoms Checklist, to help you obtain proper diagnosis and treatment.
- Medscape: Medscape Access
- Hypothyroidism Page - National Endocrine and Metabolic Diseases Information Service
- Hypothyroidism: Symptoms and Treatments of Hypothyroid Disease - Part 1: Introduction, Causes, and S
Hypothyroidism is when your thyroid doesn’t produce enough hormones. The thyroid hormones T3 and T4 help regulate your body’s metabolism and how you use energy. Get the basics on this very common thyroid condition.
- Hypothyroidism - PubMed Health
PubMed Health specializes in reviews of clinical effectiveness research, with easy-to-read summaries for consumers as well as full technical reports. Clinical effectiveness research finds answers to the question What works? in medical and health care
- Hypothyroidism - Wikipedia, the free encyclopedia
- Hypothyroidism (Underactive, Low Thyroid) WebMD: Symptoms, Causes and Treatments of Hypothyroidism a
WebMD explains what hypothyroidism is, who gets it, what symptoms to watch for, and how it's treated.
Common Lab Values For Blood Tests
TEST SHORT NAME VALUE
- Serum thyroxine T4 4.6-12 ug/dl
- Free thyroxine fraction FT4F 0.03-0.005%
- Free Thyroxine FT4 0.7-1.9 ng/dl
- Thyroid hormone binding ratio THBR 0.9-1.1
- Free Thyroxine index FT4I 4-11
- Serum Triiodothyronine T3 80-180 ng/dl
- Free Triiodothyronine l FT3 230-619 pg/d
- Free T3 Index FT3I 80-180
- Radioactive iodine uptake RAIU 10-30%
- Serum thyrotropin TSH 0.5-6 uU/ml
- Thyroxine-binding globulin TBG 12-20 ug/dl T4 +1.8 ugm
- TRH stimulation test Peak TSH 9-30 uIU/ml at 20-30 min
- Serum thyroglobulin l Tg 0-30 ng/m